AMA proposing specialty care, payment models to CMS

(HealthDay)—The American Medical Association (AMA) and other specialty societies have created new care delivery and payment models that they expect to be supported by the Centers for Medicare & Medicaid Services, according to a recent AMA news release.

The AMA has recommended detailed actions CMS should take in developing new specialty payment models, including allowing flexibility; offering risk protection for physicians; and providing timely, accurate data so physicians can benchmark their progress.

While CMS sought comments on the procedural episodes and complex chronic disease approaches, the AMA suggested that a model designed around uncomplicated chronic disease management could help prevent patients from developing more advanced disease and experiencing acute episodes. In addition, the AMA suggested another potential model for specialty-specific, risk-adjusted global payments. This model would allow larger practices or multi-specialty groups to design comprehensive, specialty-specific or condition-specific global payments that would cover all services needed to treat a specific condition managed by that specialty.

"A relatively small number of different types of payment reforms can be developed that will be applicable to a broad range of specialties and the majority of patients within each specialty," the AMA said in its comments to CMS.